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Theory I - Chapter 67 - The Patient with Blood Disorder
Dental Hygiene - The Patient with Blood Disorder
Terms in this set (80)
loss of structural differentiation with reversion to a more primitive cell type
defective development or congential absence of an organ or tissue
factor essential to normal blood clotting contained within the blood plasma; designated by Roman numerals I to V and VII to XIII; their absence, dimintion, or excess may lead to abnormalities in clotting.
Coagulation factor =
record of number of white blood cells, including the determination of the percentage of each type of cell present; the differential is used in the diagnosis of various blood disorders, infections, and other abnormal conditions of the body
Differential Cell Count =
hemorrahagic spot larger than a petechia in the skin or mucous membrane; nonelevated, blue or purplish
hemorrhage from the nose
formation of red blood cells
inflammation in the tongue
pain in the tongue
blood in a joint cavity
volume percentage of eurythocyte that transports molecular oxygen to body cells
the formation and development of blood cell; usually in bone marrow
protein in the erythrocyte that transports molecular oxygen to body cells
oxygenated arterial blood; bright red and about 97% saturated with oxygen; venous blood is a darker color and contains only 20% to 70% oxygen
rupture of eurythrocytes with the relase of hemoglobin into the plasma
diminished availbaility of oxygen to body tissues
lack of adequate amounts of oxygen that can result from the rapid diffusion of nitrous oxide molecules from the bloodstream into the lungs. Occurs if 100% oxygen is not administered at the conclusion of a nitrous oxide sedation procedure
Diffusion hypoxia =
increase in the total number of leukocytes
reduction in total number of leukocytes in the blood; count is under 500 per ml
destruction or decomposition, as of a cell, bacterium, or other substance
abnormally large red blood cell; in contrast with microcyte
young cell of the granulocyte series; occurs normally in bone marrow; found in circulating blood in certain diseases
diminished number of neutrophils
minute, pinpoint, round, nonraised, purplish-red spot in the skin or mucous membrane, caused by hemorrage.
engulfing of microorganisms and foreign particles by phagocytes such as macrophages
cell in connective tissue converted from B lymphocyte: involved in chronic inflammation and immune response
Plasma Cell =
hemmorrage into the tissues; under the skin, and through the mucus membranes; produces petechiae and ecchymoses
when circulating platelets are decreased
Thrombocytic purpura =
that something is not right.
Because Early signs of systemic disease often appear in the oral cavity. Clinical exam may the reveal what?
1. Gingival bleeding
2. Hx of controlling bleeding
3. Hx of bruising easily
4. Numerous petechiae
5. Marked pallor of the mucous membrane
6. Atrophy of the papillae of tongue
7. Acute/chronic infections
8. Severe ulcerations
9. Exaggerated gingival response
Some examples of Findings that may be suggestive of a blood disorder could be __?
normal blood composition
This is 55% plasma fluids and 45% formed elements
Adult blood cells come from __? bone marrow
90% water and 10% of: plasma proteins, inorganic salts, gases, substances being transported
Plasma for blood is composed of __?
Red Blood Cells are also called __?
red blood cells
These Transport hemoglobin, carry oxygen, and Normal values range from 12-17.2g per ml
White Blood Cells are also called __?
1. granulocytes (neutrophils, eosinophils, basophils) and
2. agranulocytes (lymphocytes, monocytes)
The two types of white blood cells are __?
These are Active in blood clotting mechanism, essential in closing capillaries at time of injury and active in clot dissolution after healing.
Neutrophils, eosinophils, and basophils are examples of __?
Lymphocytes and monocytes are examples of __?
A reduction of red blood cells which is known as normal is called?
blood loss from trauma or dx
internal, slow loss of blood usually gastrointestinal or gynecologic origin
Caused by increased hemolysis:
destruction of RBC's
Caused by diminished production of RBC's:
a nutritional deficiency or bone marrow failure
Anemia of Chronic Dx:
underproduction of RBC's
Caused by Genetic Blood Disorder:
Thalassemia (inherited condition), most severe form is known as Cooleys anemia. TX: hematopoietic stem-cell transplantation
Anemia is classified by cause. What are some causes?
hematopoietic stem-cell transplantation
How is Cooleys anemia treated?
1. Pale thin skin
2. Weakness, malaise, ease fatigability
3. Dyspnea on little exertion
4. Headache, vertigo, tinnitus
5. Dimness of vision, spots before your eyes
6. Brittle nails
Clinical Characteristics of Anemia are __?
1. Malnutrition or malabsorption
2. Chronic infection
3. Increase blood demand (ex: pregnancy)
4. Chronic blood loss (internal bleeding, excessive menstrual flow, frequent blood donations)
What are the causes of Iron Deficiency Anemia?
4. pallor of the mucosa and gingiva,
5. tongue changes,
6. angular cheilitis
What are the signs and symptoms of Iron Deficiency Anemia?
Oral ferrous iron tablets
Treatment for Iron Deficiency Anemia is __?
1. Pernicious Anemia:
2. Folate deficiency Anemia
Megaloblastic Anemias include:
This condition causes a deficiency of vit B12, Impaired absorption of vit B12 and usually occurs in adults over age 40
Vit B12 administered by injection 2 x week till controlled then monthly indefinitely.
What is the treatment for pernicious anemia?
Folate deficiency Anemia
This condition is characterized by an inadequate diet, impaired absorption, pregnancy, cancer and/or certain drugs
Dietary sources: fresh fruit, green leafy veggies, dairy products, whole grain cereals
How is Folate deficiency Anemia treated?
T/F Folate deficiency is not uncommon?
Sickle Cell Crisis
This is a periodic recurrence of clinical exacerbations of the dx with periods of remission characeterize childhood and adolescence
1. Radiographs-decreased radiodensity, increased osteoporosis, coarse trabecular pattern, significant bone loss in children
2. Generalized pallor of tissues, jaundiced color, periodontal involvement,
Oral findings with patient having sickle cell disease are __?
1. Teach and supervise good OH,
2. use prophylactic antibiotics,
3. short appts,
4. use local anesthesia,
5. use nitrous oxide
Appointment mgmt for patients with anemia includes?
An increase in the number and concentration of RBC's above the normal level is known as __?
Polycytheia vera is also known as __?
Polycytheia vera (primary polycythemia)
Oral Characteristics of this blood disorder include:
1. tongue, mucous membranes and gingiva deep purplish red,
2. gingiva enlarged with bleeding,
Characteristics of this blood disorder include:
1. Increased number in RBC's, can result from high altitudes, pulmonary dx, heart dx, or smoking
Disease or Intoxification of the Bone marrow:
due to chronic drug poisoning, radiation, autoimmune or drug induced immune reactions may be implicated.
2. typhoid fever,
5. measles and german measles
Conditions in which leukopenia occurs:
Agranulocytosis is also known as __?
Agranulocytosis (malignant neutropenia
This is a rare, serious dx involving destruction of bone marrow, toxicity from drugs and chemicals, an increase in susceptibility to infection, a sharp drop in WBC's and a depression of bone marrow. It is rapid acute illness leading to death.
This condition is characterized by an Increased number of circulating WBC's. It is caused by inflammatory and infectious states, trauma and exertion and the most common of these is Leukemia.
2. Platelet dysfunction
3. Acquired disorders
4. Hereditary disorders
Some types of bleeding disorders are:
This is a bleeding disorder in where the lowered number of platelets caused by decreased production in bone marrow. May be due to leukemia, deficiencies such as folate or B12 def anemias.
This blood disorder is caused by an Interference with blood clotting
These are blood disorders that occur due to: a Vitamin K deficiency, liver disease or anticoagulation drugs.
at least 30
How many hereditary blood disorders exist?
1. Hemophilia A or Classis hemophilia
2. Hemophilia B or Christmas Dx
3. Von Willebrand's Dx
What are the 3 common forms of coagulation disorders?
Hemophilia A or Classis hemophilia
This is the most common form of hemophilia. 85% people with hemophilia have this type. It is caused by reduced amountt of reduced activity of factor VIII.
Hemophilia A is also called?
Hemophilia B is also called?
Hemophilia B or Christmas Dx
This type of hemophilia is Caused by deficiency of a blood plasma protein called factor IX that affects clotting properties of blood.
Both Hemophilia A and B are __ genetic diseases.
The defective gene for Hemophilia A and B is found on __ so it primarily affects males.
Von Willebrand's Dx
This type of hemphilia involves Prolonged bleeding; it is the most common hereditary disorder of platelet function and occurs in both males and females
most common hereditary disorder of platelet function
Von Willebrand's Dx
1. Effects of minor trauma: depends on trauma
2. Hemarthroses: bleeding into soft tissues of joints (knees, ankles, elbows) begins in very young with hemophilia. Swelling, pain and incapacitation.
3. Joint deformity and crippling: permanent joint damage can occur. Patient may need splint, braces, orthopedic surgery
4. Intramuscular hemorrage: hemorraging into muscles is accompanied by pain and limited motion.
5. Oral bleeding: bleeding from gingiva is common more when perio dx involved. Because of bleeding patients may slack on OH. When trauma occurs severe bleeding can result.
What are the Effects and long-term complications of hemophiliacs?
1. Patient history:
Type, severity, tx, meds, and family hx of blood clotting defect
2. Consult with physician/hematologist
To obtain complete info
3. Preparation for clinical appt
Tests may be needed prior to tx, pre-med may be required
4. Primary screening tests
See Table 64-1 for PT, PTT, platelet count
5. Clinical procedures
Good OH, condition for less bleeding, scale in short intervals
6. Oral hygiene program
GOOD OH, soft TB
The dental hygiene care plan for hemophiliac patients includes the following:
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